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General NPI Number Information
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NPI Number | 1720419302
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Entity Type | Organization
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Legal Business Name | UNIVERSAL FOOTCARE AND PODIATRY, INC
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 541 W COLORADO ST STE. 206
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City | GLENDALE
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State | CA
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Zip | 91204-3638
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Country | US
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Telephone | 818-244-4008
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Fax |
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Provider Business Mailing Address
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Address Line | 541 W COLORADO ST STE. 206
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City | GLENDALE
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State | CA
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Zip | 91204-3638
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Country | US
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Telephone | 818-244-4008
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SEONG M YOO
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Credential | DPM
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Telephone | 818-244-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | E4519
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License Number State | CA
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